Elder abuse in the home is on the rise

By Frank G. Runyeon

An increasing number of elderly New Yorkers are being exploited financially, state officials report, indicating that this group may also be suffering increasing rates of other forms of abuse.

Between 2010 and 2015, reports of elder financial exploitation rose by 50 percent in New York City and 45 percent statewide, reaching a total of 4,351 last year, according to the New York State Office of Children and Family Services (OCFS). While many more cases of abuse go uncounted, an agency spokesman said, the number of reported cases continues to rise.

Elder abuse includes a number of forms of exploitation of an individual age 60 or older. The abuse can be verbal, physical, psychological, sexual, or the result of neglect – but most often it involves financial exploitation. While abuse in nursing homes or other long-term care facilities remains a serious issue, as previously reported by New York Nonprofit Media, researchers say most elder abuse occurs in seniors’ own homes.

Nonprofit leaders describe elder abuse prevention efforts as decades behind domestic violence or child abuse prevention efforts, even though abuse of the elderly is more prevalent.

In fact, there are more victims of elder abuse in the United States every year than victims of child abuse or domestic violence combined, according to recent estimates. Elder abuse at home affects an estimated 5 million people nationally, studies indicate. A 2011 study in New York estimated that 260,000 senior citizens suffered abuse during a 12-month period between 2008 and 2009.

“It's a huge problem that's exploding on us,” said Risa Breckman, executive director of the NYC Elder Abuse Center. “Just looking at the demographics, it's going to get worse if we don't start putting in place prevention programs,” not just programs that assist abuse victims after the fact.

Elder abuse is linked to a long list of undesirable outcomes, Breckman said, such as increased hospital use, a higher likelihood of going into a nursing home, deteriorating mental health, financial hardship and premature death. “The consequences are enormous,” she said.

According to a study by OCFS released in June, financial exploitation of elderly New Yorkers costs the state and victims an estimated total of between $352 million and $1.5 billion per year. The staggering sum calls into question previous estimates, which “may have grossly underestimated the magnitude of losses,” the study’s authors wrote.

Still, the true cost of elder abuse is difficult to measure.

”Quantifying this is pretty much impossible,” said Elizabeth Loewy, a former Manhattan assistant district attorney who headed the borough’s elder abuse unit before joining EverSafe, a tech startup focused on preventing financial exploitation. Recalling her 29 years in the district attorney’s office, Loewy said the unit handled 800 elder abuse cases a year.

Time after time, caregivers and adult children came into her office and cried, Loewy said. “And all they would say is, ‘If I had only helped. If I had only stepped in. I was worried about seeming like I was trying to take over,’” Loewy recalled.

“It would kill me,” she said. “Seniors left with nothing.”

Social workers and researchers have a catalog of tragic stories: Women and men quietly suffering decades of violence, overworked caregivers berating their elderly charges, and insolvent adults siphoning funds from people’s life savings.

But most often, such abuse isn’t the result of ruthless orderlies or over-the-phone scammers, as many assume, Loewy said. As in the case of the opulently wealthy Manhattan socialite Brooke Astor – whose son, Anthony Marshall, along with an estate lawyer, stole tens of millions of dollars from her – family members and trusted aides are usually the culprits.

Loewy said law enforcement officers who call her for advice tend to downplay abuse cases as “a family matter” when outside actors aren’t involved. “It is different,” Loewy said. “To me, it’s worse. Your family should be there to take care of you. Not rip you off until you have no money left,” she said.

The way trusted family members become abusers is often as complex as it is unsettling. Art Mason, who leads the elder abuse prevention program at LifeSpan of Greater Rochester, said his team of social workers has seen a series of emerging trends.

One persistent pattern involves addicted individuals who take advantage of their parents or grandparents, stealing from them to pay for drugs – particularly heroin of late, Mason noted. Another growing trend is gambling addicts financially abusing elderly family members. Mentally challenged individuals can also sometimes become abusers of elderly family members who they are ill-equipped to understand or assist.

A very different group, Mason notes, are domestic violence abusers.

"Another family type that we're seeing more and more of is really the purely domestic violence in later life,” Mason said. If the violence is longstanding, by the time it becomes elder abuse, the victim almost never leaves, he said. “They stay because in that generation the husband worked outside of the house so the income is coming through husband and his pension, the health care is through him, and so (abuse victims) don't leave, they stay. So, they're very hidden.”

“It's domestic violence grown old,” said Jenny Hicks, program coordinator at Vera House, a nonprofit serving victims of domestic violence and sexual violence, as well as elder abuse in Syracuse. “It’s exploitation by kids, grandkids. It really is a pretty broad spectrum."

“We had someone stay at our shelter, she was in her 80s dating a man in his 70s who was physically abusing her – that's elder abuse,” said Hicks.

Recently, “elder justice” efforts have focused on the issue of financial exploitation, several industry veterans said, in part because it is one of the easiest forms of abuse to quantify but also because it is less distasteful to consider than other forms of abuse. Most people don’t want to directly grapple with the ugly acts involved in neglect or physical, psychological or sexual abuse.

“It’s the one that’s easiest to understand,” Mason explained.

There are also clear financial incentives for the banks and governments sponsoring the financial exploitation focus. After all, money stolen from elderly investment or savings accounts is no longer benefitting bankers or brokers, and newly destitute New Yorkers are sure to be a drain on Medicaid funds as well.

And considering how often victims of financial exploitation also suffer other forms of elder abuse, several nonprofit providers said they welcomed the attention. As it is, they said, there’s scant funding for the aging sector as a whole, much less for elder abuse.

“There's no designated federal support for adult protective services. Zero,” said Kathleen Quinn, executive director of the National Adult Protective Services Association (NAPSA), a national nonprofit membership group. As a result, much funding is determined by the state.

Quinn praised New York for funding some of the leading research studies and educational initiatives, including state-funded training for its county-based elder abuse programs. Nevertheless, tracking down New York state’s spending on elder abuse programs has proven elusive for NAPSA, which has made attempts to get the data in the past.

“This has always been a mystery for me that we can’t get that information,” Quinn said, noting that she hoped New York planned on sharing the information in a new nationwide database that should go online next spring.

While the state allocated $110 million to reimburse service providers for all adult protective services and domestic violence initiatives, an OCFS spokesman said he could not characterize what proportion of the total funding goes to elder abuse initiatives and that spending data solely for elder abuse was not readily available.

Downstate, New York City has taken laudable steps, advocates said, including allocating $1.5 million to fund multidisciplinary teams to manage elder abuse cases referred to them. But while such funding is a good start, it doesn’t come close to meeting the need.

“When you think about $1.5 million and you think about New York City, it's a big city, there's huge need,” Risa Breckman, who heads the NYC Elder Abuse Center, said earlier this year. The funds must be used to pay medical specialists, psychiatrists and forensic accountants. “We could very well need additional funds,” she said.

Elder abuse prevention programs don’t fare much better. Federal funding for elder abuse programs is a fraction of spending on family violence issues – about 0.3 percent. While $6 billion was spent on child abuse, and $249 million on intimate partner violence, just $19 million was spent on elder abuse, according to a factsheet prepared by the Grantmakers in Aging.

Spending shortfalls may be indicative of a larger problem in combating elder abuse, experts fear – a cultural indifference to the suffering of the elderly.

“If we really want to be a society where we're working to prevent abuse from occurring, and be more responsive after it occurs, we need to step it up because it's happening to millions of people – millions and millions,” Breckman warned. “And it's going to just grow if we don't do something.”